Endocrine Abstracts

Introduction: Hypercalcaemia accounts for 0.6% of all acute medical admissions1, with primary hyperparathyroidism and malignancy-associated hypercalcaemia contributing to 90% of these cases.Case Presentation: A 67-year-old female was initially seen in neurology clinic with a 3-year history of subtle word-finding difficulties, episodic confusion, and balance problems. On further probing, she reported constipation, polyuria and polydipsia, but h...

Case history: Case 1: 18-year-old female referred with asymptomatic hypercalcaemia (adjusted calcium 2.69 mmol/l), phosphate 0.96 mmol/l, parathyroid hormone 2.6 pmol/l and total 25 hydroxyvitamin D 37 nmol/l. No evidence of end organ damage. Initial calcium: creatinine clearance ratio 0.0033 but the patient had a vitamin D 24 nmol/l. Case 2: A 53-year-old female referred with asymptomatic incidental hypercalcaemia (adjusted calcium 2.73–2.87 mmol/l), raised parathyroid h...

A 49-year-old female was admitted to with diabetic ketoacidosis (DKA) and newly diagnosed diabetes. Her only significant medical problem was malignant hypertension with poorly controlled blood pressure (BP) on four antihypertensive agents. She reported no exogenous glucocorticoid or liquorice ingestion. She also complained of a 6-month history of lethargy, weight gain, and a two-month history of easy bruising, lower-limb weakness, increasing polyuria and polydipsia. There was ...

A 49-year-old female was admitted to medical HDU with diabetes ketoacidosis (DKA) and newly diagnosed diabetes. Six months previously she was diagnosed with malignant hypertension. She had poorly controlled blood pressure despite treatment with four anti-hypertensives, which were her only regular medication. She had never used any medications or creams containing glucocorticoids. She had no history of hypokalaemia and reported no use of liquorice. She recently attended an outp...

Case History: 69 years old gentleman was referred to endocrinology for investigation of a benign appearing left incidental adrenal adenoma (1cm) after being investigated for abdominal pain. He had a past medical history of an abdominal aortic aneurysm (AAA), type 2 diabetes mellitus and hypertension.Investigations: Initial endocrine investigations revealed normal 24h urinary free cortisol levels (twice), metanephrines and ARR. His overnight dexamethasone...

A 33 year old white European patient presented at 32 weeks gestation with a three day history of severe epigastric pain radiating to left flank with vomiting. She had pre-existing hypertension, controlled with labetalol. On admission, her BP dropped from 170/100mmHg to 90/70mmHg. Abdominal examination revealed epigastric tenderness without peritonism. There were no Cushingoid features. An abdominal ultrasound scan was normal. An MRI scan showed a bulky left adrenal gland, with...

Introduction: Prolonged therapy with high-dose corticosteroids (≥ 7.5 mg Prednisolone or 1–1.5 mg Dexamethasone daily) can result in adrenal atrophy and hypofunction. Abrupt withdrawal of corticosteroids after prolonged use can lead to adrenal insufficiency, corticosteroid withdrawal symptoms or a relapse of the initial disease. There are several in-house protocols for safe corticosteroid dose tapering but a national protocol is required.Our p...

Introduction: Glycated haemoglobin (HbA1c) is used to measure glycaemic control in patients with diabetes, and accuracy depends on normal erythrocyte lifespan. Dapsone causes spuriously low HbA1c results by reducing erythrocyte lifespan through haemolysis and methaemoglobin formation, which interferes with the liquid-chromatography method used to measure HbA1c. Dapsone-induced haemolysis (DIH) is mostly reported in patients with glucose-6-phosphate dehydrogenase (G6PD) deficie...

The role of magnesium in electrolyte homeostasis is well established. ATP/ADP structure, refractory hypokalemia and calcium homeostasis are some of the established roles in literature, well known to Endocrine. However, currently no NICE guidelines exist for low magnesium. Our first audit in 2018 focused on patient admissions during January 2018. We found 49 patients with Mg < 0.5. Majority were care of the Geriatrics, 8 under Gastroenterology, 4 under Endocrinology. 31 pat...

A 25 year old Afghan male presented with a 4 day history of worsening left-sided loin pain. He had a past history of deafness since birth, speech problems and development delay. Bilateral renal calculi and widespread multiple well defined lytic lesions (likely brown tumours) were seen on CT-KUB. The corrected calcium was 3.21 mmols/l, PTH 80 pmol/l, Vitamin D 25 nmol/l, phosphate 0.49 mmols/l, ALP 960 IU/l and fractional calcium excretion was 0.16. His skull X Ray/OPG, done du...